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What is Tongue Thrust?
by Natalie J. Dahl, M.S., CCC-SLP
Did you know a child swallows 2,000 times each day? Now imagine if every time a child swallows, his tongue pushes against his front teeth… that’s 2,000 times every day that his teeth are pushed against and slightly moved forward! This habit is called tongue thrust and it can cause problems for dentition, biting, chewing/eating, and sometimes speech.
What is tongue thrust? Tongue thrusting is the habit of pushing the tongue against or between the front teeth when swallowing and/or speaking. It is also commonly referred to as a reverse or immature swallow and is normal in infants and toddlers. Normally, children will outgrow this pattern of swallowing; however, if they do not, a trained speechlanguage pathologist (SLP) can help re-train the muscles to a normal swallowing pattern.
What causes tongue thrust? There are several possible causes of tongue thrust: oral habits (e.g., thumb sucking, fingernail biting, lip picking, teeth clenching and grinding), allergies, enlarged tonsils and adenoids, and/or hereditary factors.
What are the effects of tongue thrust?
  • Speech: If speech is affected, the sounds most likely produced incorrectly are S, Z, SH, ZH, J, and/or CH. For example, a child may say “thun” instead of “sun” because his/her tongue is too far forward while speaking. Also, the sounds T, D, N, and L may be distorted because of weak tongue tip muscles. Sometimes, however, speech may not be impacted at all.
  • Dentition: Because the tongue is pushing excessively on the front teeth, the teeth may be repositioned forward and upward into an open bite. An open bite occurs when a child bites his/her back molars together but the front top and bottom teeth do not touch. Tongue thrust can reverse orthodontic work that has already been done.
  • Eating: A child with tongue thrust will often chew food with his/her lips open, take large bites, and swallow before completely chewing the food. This can lead to noisy chewing and swallowing and a messy eating area. It may also cause an upset stomach from swallowing too much air while eating.
Can tongue thrust be corrected? Tongue thrust can be diagnosed by a dentist, an orthodontist, a doctor, or SLP. An SLP can create a therapy plan to help remediate tongue thrust. This plan might include goals to:
  • decrease unwanted oral habits (e.g., thumb sucking)
  • improve awareness of muscles used in the mouth and face
  • improve awareness of mouth and tongue postures
  • improve muscle coordination and strength
  • improve articulation skills
  • improve swallowing patterns
In order to qualify for therapy services at school from an SLP, a child’s disability has to negatively impact access to his/her education. Tongue thrust alone most likely will not have this adverse impact; however, if the tongue thrust is causing articulation errors, a child may be eligible to receive speech therapy at school. Contact your local SLP if you are interested in learning more about tongue thrust and/or articulation therapy.
Resources
“Orofacial Myofunctional Disorders (OMD),” American Speech-Language-Hearing Association (ASHA), accessed September 9, 2016, http://www.asha.org/public/speech/disorders/OMD/.
“Orofacial Myofunctional Disorders,” International Association of Orofacial Myology (IAOM), accessed September 9, 2016, http://www.iaom.com/OMDisorders.html.
“Tongue Thrust Exercise,” Pedodontics, P.C., accessed September 8, 2016, http://www.pedodonticspc.com/orthodontic-treatment/braces/tongue-thrust-exercise.aspx.
“Tongue Thrust Therapy,” Achieve Center Pediatric Therapy, accessed September 8, 2016, http://www.achievecenter.net/tongue-thrust-therapy.html
 
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